CN113274123B

CN113274123B - Clamp with tissue stop

Info

Publication number: CN113274123B
Application number: CN202110545109.3A
Authority: CN
Inventors: Z·R·沃德; T·W·沙拉特
Original assignee: Gyrus ACMI Inc
Current assignee: Gyrus ACMI Inc
Priority date: 2016-01-11
Filing date: 2017-01-11
Publication date: 2024-06-14
Anticipated expiration: 2037-01-11
Also published as: CN108430350A; US12016733B2; CN113274123A; CN108430350B; US20170196648A1; WO2017123584A1; US10722317B2; US20200281683A1

Abstract

An instrument includes a clamp. The pliers include a jaw assembly. The jaw assembly includes a first jaw and a second jaw. The first jaw includes a gripping portion and the second jaw includes a gripping portion. The jaw assembly is movable between an open position and a closed position. The first jaw is electrically conductive and the second jaw is electrically conductive, or both the first jaw and the second jaw are electrically conductive. The first jaw includes a first tissue stop centered on an inner plane of the first jaw. The tissue stop extends from the first jaw toward the second jaw. The first tissue stop is adapted to inhibit anatomical features from extending beyond a proximal end of the gripping portion of the first jaw, a proximal end of the gripping portion of the second jaw, or both.

Description

Clamp with tissue stop

The application is a divisional application of a Chinese patent application with the application number 201780004943.3, the application date 2017, 1 month and 11 days and the application name of 'clamp with tissue stopper'.

Technical Field

These teachings relate to instruments and, more particularly, to jaws that include one or more tissue stops.

Background

A clamp is a forceps-like instrument having opposed jaws. Jaws may be used during a medical procedure to affect anatomical features such as blood vessels or tissue. For example, a blood vessel or tissue can be positioned between the gripping portions of opposing jaws, and the jaws can be used to move, grip, grasp, push, pull, cut, dissect, and/or otherwise affect the blood vessel or tissue. Some clamps also have electrosurgical capabilities for electrically affecting anatomical features. For example, a vessel or tissue may be sealed or coagulated with electrosurgical current delivered from or between one or both of the jaws.

Before affecting the anatomical features, care should be taken to properly position or locate the anatomical features between the gripping portions of the opposing jaws. For example, if a blood vessel or tissue is positioned or positioned too far in a proximal direction between the jaws, e.g., beyond the proximal end of the gripping portion, the blood vessel or tissue may not be securely held or gripped, which may undesirably traumatize the anatomical feature while affecting the anatomical feature. In addition, some clamps have hinges or other pivoting mechanisms that allow one or both of the jaws to move toward and away from each other. A blood vessel or tissue positioned too far in the proximal direction may be clamped in the hinge or pivot mechanism, which may undesirably result in bleeding or trauma to the anatomical feature.

In addition, when electrosurgical forceps are used, if the blood vessel or tissue is positioned too far in the proximal direction, e.g., beyond the conductive portions of one or both of the jaws, that portion of the blood vessel or tissue may not be adequately sealed or coagulated. Advancing the cutting blade over or through a portion of the blood vessel or tissue that is not sufficiently coagulated may undesirably result in bleeding or trauma to the anatomical feature.

Accordingly, there is a need in the art for improvements that are readily apparent. For example, it may be desirable to provide a clamp that includes one or more features that can assist a surgeon in positioning anatomical features between the jaws. It may be desirable to provide a clip that includes one or more features that may prevent or at least reduce the chance of anatomical features being positioned or disposed too far in a proximal direction between the jaws. For example, it may be desirable to provide a clamp that includes one or more features that can help position anatomical features between the gripping portions of the jaws and thereby reduce the chance of the anatomical features being clamped in the hinge or pivot mechanism of the clamp. For example, it may be desirable to provide a clip that includes one or more features that can help position anatomical features between conductive portions of the jaws of an electrosurgical clip so that the entire anatomical feature can be properly sealed or coagulated.

Disclosure of Invention

These teachings advantageously provide a clamp that includes one or more tissue stops. One or more tissue stops can advantageously assist the surgeon in positioning anatomical features between the jaws. The one or more tissue stops may prevent, or at least reduce the chance that the anatomical feature will be positioned too far in the proximal direction between the jaws. One or more tissue stops can help position anatomical features between the gripping portions of the jaws and thereby reduce the chance that some or all of the anatomical features will be pinched between the hinge or pivot mechanisms of the jaws. One or more tissue stops can help position the anatomical feature between the conductive portions of the jaws so that the entire anatomical feature can be sufficiently coagulated during the electrosurgical procedure. By incorporating one or more tissue stops into the clip according to the teachings herein, the time taken to ensure that the anatomical feature is properly positioned between the jaws may be reduced.

The instrument includes a jaw including a jaw assembly. The jaw assembly includes a first jaw and a second jaw. The first jaw includes a gripping portion and the second jaw includes a gripping portion. The jaw assembly is movable between an open position and a closed position. The first jaw is electrically conductive and the second jaw is electrically conductive, or both the first jaw and the second jaw are electrically conductive. The first jaw includes a first tissue stop centered on an inner plane of the first jaw. The first tissue stop extends from the first jaw toward the second jaw. The first tissue stop is adapted to prevent the anatomical feature from extending beyond a proximal end of the gripping portion of the first jaw, a proximal end of the gripping portion of the second jaw, or both.

The instrument includes a jaw including a handpiece and a jaw assembly. The jaw assembly is connected to the handpiece. The jaw assembly includes a first jaw and a second jaw. The first jaw includes a gripping portion and the second jaw includes a gripping portion. The jaw assembly is movable between an open position and a closed position. A portion of the first jaw is electrically conductive, a portion of the second jaw is electrically conductive, or a portion of both the first jaw and the second jaw are electrically conductive. The first jaw includes a first tissue stop centered on an inner plane of the first jaw. The first tissue stop extends from the first jaw toward the second jaw. The first tissue stop overlaps the second jaw when the jaw assembly is in the open position at a position proximal to an end of the gripping portion of the first jaw, at a position proximal to an end of the gripping portion of the second jaw, or at both positions.

The instrument includes a jaw including a jaw assembly. The jaw assembly includes a first jaw and a second jaw. The first jaw includes a gripping portion and a first tissue stop, and the second jaw includes a gripping portion and a slot defined between two opposing outer edges. The first tissue stop is generally U-shaped and includes an inner leg, an outer leg, and a gap defined between the inner leg and the outer leg. The inner leg is centered on the inner plane of the first jaw. The jaw assembly is movable between an open position and a closed position. When the jaw assembly is moved to the closed position: a portion of the inner leg is received into the slot of the second jaw; the outer side of the inner leg is juxtaposed with one of the two opposing outer edges of the slot; the inner side of the outer leg is juxtaposed with the outer side of the second jaw; and a portion of the second jaw is received into the gap. At least one of the inner leg and at least a portion of the outer leg overlaps the second jaw at a location proximal to an end of the gripping portion of the first jaw, at a location proximal to an end of the gripping portion of the second jaw, or at both locations when the jaw assembly is in the open position.

Drawings

FIG. 1 is a perspective view of an instrument including a jaw assembly.

Fig. 2 is a perspective view of a jaw element of the jaw assembly.

Fig. 3 is a perspective view of a jaw assembly.

Fig. 4a is a side perspective view of the jaw assembly.

Fig. 4b is a front perspective view of the jaw assembly of fig. 5.

Fig. 5 is a schematic top view of the jaw assembly.

Fig. 6 is a perspective view of a jaw assembly.

Fig. 7 is a perspective view of a jaw assembly.

Detailed Description

This disclosure claims the benefit of U.S. provisional patent application No. 62/277,037 filed on 1/11/2016, which is hereby incorporated by reference in its entirety for all purposes.

An instrument. These teachings provide an instrument. The instrument may be any instrument for influencing an object. Influencing may mean, for example, manipulating, engaging, moving, grasping, holding, pushing, pulling, cutting, tearing, coagulating, sealing, cauterizing, dissecting, electrocautering, or otherwise influencing an object or anatomical feature. The object may be any object, whether or not it is an anatomical feature. The anatomical feature may be, for example, a blood vessel, tissue, vein, artery, any portion of an anatomical structure, or a combination thereof.

The instrument may be used in a medical related procedure or a non-medical related procedure. The instrument may be used in open and/or laparoscopic or minimally invasive procedures. The instrument may be a medical clamp, a cutting clamp, an electrosurgical clamp, a bipolar clamp, or the like, or a combination thereof.

The instrument may be used with or without electrical charge. When used electrically, the instrument can be used in electrosurgical procedures. The instrument may be in electrical communication with a suitable power source so that the instrument may be used in a bipolar circuit. For example, suitable electrical current, therapy, and/or signals provided by the power source can be transferred from, through, or between the jaws, grip portions, conductive portions, electrodes, or combinations thereof to electrically influence the anatomical feature. For example, the anatomical feature can be sealed or coagulated between the gripping or conductive portions of the opposing jaws with a bipolar therapeutic signal provided by a power source. That is, the opposing jaws of the instrument can be in communication with opposing poles of a power source such that the instrument can function as a bipolar forceps and seal and coagulate anatomical features between the jaws. As will be discussed further below, the instrument also includes a cutting burr that can be advanced through the coagulated or sealed anatomical feature.

A hand piece. The instrument may comprise a handpiece. The handpiece may be used to house, support and/or contain one or more components of the instrument. For example, the handpiece may house, support, and/or contain the parts or components required to move or actuate the jaw assembly, one or more jaws, a cutting knife, or a combination thereof. The handpiece may house, support and/or contain the parts, components, electrical conductors or wires required for the electrosurgical function of the instrument. The instrument, the handpiece, or both may include sufficient controls for operating, actuating, and/or manipulating the instrument. The controls may include wheels, triggers, levers, buttons, and the like, or combinations thereof. One or more of these controls can be manipulated or moved to open/close the jaw assembly; moving one or more of the jaws toward or away from each other; a rotary jaw assembly; advancing or retracting the jaw assembly; advancing or retracting the tubular member; advancing or retracting the cutter; applying a therapeutic current; or a combination thereof. For example, manipulation or movement of the lever can be adapted to move the jaw assembly (i.e., move one or more of the jaws) from an open position to a closed position, and vice versa. For example, manipulation or movement of the wheels can be adapted to rotate the jaw assembly about a longitudinal axis of the jaw assembly, the tubular member, or both. For example, manipulation or movement of the trigger may be adapted to translate or reciprocate the cutting blade about a longitudinal axis of the cutting blade, tubular member, jaw assembly, or combination thereof. For example, manipulation or movement of the button may be adapted to apply a therapeutic current or signal from a power source to the jaw assembly, one or both of the jaws, one or more of the gripping portions, one or more of the conductive portions, one or more of the shims, one or more of the electrodes, or a combination thereof to affect the anatomical feature.

A tubular member. The tubular member may be used to allow a portion of the instrument to be inserted into a patient or anatomy while a portion of the instrument remains outside of the patient or anatomy. The tubular member may be configured to be inserted into an anatomical structure through a trocar. The tubular member may allow the jaw assembly and/or one or more functional elements of the instrument to be manipulated without obstruction from the trocar, the anatomy, or both.

The tubular member may be an elongated member extending along a longitudinal axis. The proximal end of the tubular member may be connected to a handpiece. The distal end may define a mouth or opening (i.e., a distal opening). The tubular member may be at least partially hollow and may define an interior portion therein. The hollow or inner portion of the tubular member, the distal opening, or both, are sized sufficiently such that one or more jaws, a jaw assembly, a cutting knife, one or more tissue stops, an arcuate portion, or a combination thereof, can be received and/or moved within the tubular member. The tubular member may be substantially straight; may include one or more angles, bends or arcs; or a combination thereof. The tubular member may be substantially rigid, substantially flexible, substantially elastic, or a combination thereof.

In some configurations, the tubular member can be movable relative to the arcuate portion, the handpiece, or a combination thereof (i.e., axially, distally, proximally, rotationally, or a combination thereof). The tubular member is movable by manipulating one of the user controls on the handpiece. The tubular member may be movable relative to the jaw assembly, the handpiece, or both, such that the jaw assembly is movable or deflectable between an open position and a closed position. More specifically, by manipulating one or more user inputs, the tubular member can be moved in a first direction (i.e., distally relative to the handpiece) and over, and/or onto the arcuate portions of one or both of the jaws such that the jaw assembly can be moved into a closed or gripping position. Of course, by manipulating one or more user inputs, the tubular member can be moved in a second direction (i.e., proximally relative to the handpiece) such that the tubular member moves away from the arcuate portion, thereby allowing one or both of the jaws to relax or flex into an open, steady-state position. In this type of configuration, the jaw assembly is preferably secured to the handpiece and does not move distally or proximally relative to the handpiece.

Additionally or alternatively, the tubular member can be fixed relative to the handpiece, and the jaw assembly can be movable. In this configuration, by manipulation of one or more user inputs, the jaw assembly can be moved in a first direction (i.e., proximally toward the handpiece) such that the tubular member or the mouth or opening of the tubular member acts on the arcuate portion of one or both of the jaws such that the jaw assembly can be moved into a closed or gripping position. Similarly, by manipulating one or more user inputs, the jaw assembly can be moved in a second direction (i.e., distally toward the handpiece) such that the tubular member or the mouth or opening of the tubular member moves away from the arcuate portion of one or both of the jaws such that the jaw assembly can relax or flex into the open position.

A jaw assembly. The device may include a jaw assembly; the jaw assembly may be configured to perform one or more influencing functions. For example, the one or more influencing functions may include: capturing an object or anatomical feature; grasping an object or anatomical feature; providing a clamping force to secure an object or anatomical feature; providing for retraction of the object or anatomical feature; providing a compressive force across an object or anatomical feature captured in the jaw assembly; or a combination thereof. The anatomical feature may be, for example, a blood vessel, tissue, vein, artery, a portion of an anatomical structure, or a combination thereof.

The jaw assembly may be used in electrosurgical procedures to perform one or more electrical functions, such as cutting, coagulating, cauterizing, dissecting, and/or electrocautery object anatomical features.

The jaw assembly is movable between a closed position and an open position. More particularly, the jaw assembly can include one jaw that moves relative to the other jaw such that the jaw assembly moves between an open position and a closed position. The moving jaw may include one or more tissue stops. Additionally or alternatively, the non-moving jaw may include one or more tissue stops. Alternatively, the jaw assembly may include a pair of opposing jaws that move toward each other into a closed position and away from each other into an open position. In this configuration, one or both of the jaws may include one or more tissue stops.

In some configurations, the jaw assembly can be moved into the closed position by applying a force to one or both of the arcuate portions of the jaws, which, as described below, causes one or both of the jaws to move toward each other into the closed position. Instead, the jaw assembly is preferably moved into the open position by removing force from one or both of the arcuate portions of the jaws, which causes one or both of the jaws to relax and resiliently move away from each other into the open position.

In other configurations, the jaw assembly may include a hinge or other pivoting mechanism for pivoting the jaw assembly between the open and closed positions.

The closed position of the jaw assembly may be defined as a position of the jaw or jaw assembly in which there is little or only a slight gap between the gripping portion, the conductive portion, the jaw, or a combination thereof. In the closed position, the gripping or holding force of the gripping portion, the conductive portion, the jaws, or a combination thereof may be higher or greater than the gripping or holding force between the gripping portion, the conductive portion, the jaws, or a combination thereof when the jaws are in the open position.

The open position may be defined as a position of the jaw or jaw assembly in which there is a gap between the gripping portion, the conductive portion, the jaw, or a combination thereof. In the open position, the gripping or holding force of the gripping portion, the conductive portion, the jaws, or a combination thereof may be less than or lower than the gripping or holding force between the gripping portion, the conductive portion, the jaws, or a combination thereof when the jaws are in the closed position.

In the neutral or steady state position, the jaw assembly may be in an open position or a closed position.

The jaw assembly may be rotated relative to the handpiece or tubular member by manipulating or moving one or more of the controls on the handpiece described above when the jaw assembly is in the open position, the closed position, or a position therebetween. Rotating the jaw assembly may enable a user to change the orientation or proximity of the jaw assembly relative to anatomical features without twisting or adjusting the handpiece into a difficult or uncomfortable position, for example.

And a jaw. The jaw assembly may include one or more jaws. The jaws may be moved, adjusted, manipulated, repositioned, opened, closed, rotated, advanced, retracted, or otherwise articulated to perform one or more of the influencing functions described herein. The jaws may be moved, adjusted, manipulated, repositioned, rotated, advanced, retracted, or otherwise articulated as the jaw assembly is moved between the open and closed positions by moving or manipulating one or more of the user controls on the handpiece.

The jaws may be arranged opposite each other. The jaws may include an upper jaw and an identical lower jaw. Alternatively, the opposing jaws need not be identical. In other words, the geometry of the upper jaw may be different from the lower jaw. For example, one of the jaws can include a flexing portion having one or more arcuate portions or sections, and another of the jaws can have no flexing portion, one or more arcuate portions or sections. The jaws may be substantially rigid; substantially flexible; substantially elastic, or a combination thereof. That is, the jaws may have one or more portions that are substantially rigid; one or more portions that are substantially flexible; one or more substantially elastic portions, or a combination thereof. Preferably, at least one of the jaws, or a portion thereof, is bendable such that the jaw assembly is movable between the open and closed positions by applying a force on one or both of the jaws, as described above. Preferably, at least one of the jaws, or a portion thereof, is resilient such that the jaws are movable between the closed position and the open position by release of force from one or both of the jaws, as described above.

The jaws may be made of any suitable material. Preferably, the jaws are made of a material that is suitable for medical procedures, and that is flexible and strong. For example, the jaw elements may be made of sheet metal or wire. For example, the jaws may be formed by any suitable process, such as stamping, metal Injection Molding (MIM), or plastic injection molding. The jaws may be made of a material that can deliver electrical current such that one or more of the jaws may be used in electrosurgical procedures. One or both of the jaws, or portions thereof, may be electrically conductive. One or both jaws, or portions thereof, may be non-conductive. The jaws may be thermally insulated such that a thermal barrier may be provided between the jaws, the jaw assembly, or both. In some applications, an insulated jaw may be preferred such that thermal diffusion is limited or reduced. One or more portions of the jaws may be covered or coated with an insulating material so that if the jaws are in contact with each other or with another object or feature of the instrument or the surrounding environment, electrical shorting may be prevented.

Each of the jaws may include one or more jaw portions. As used herein, a jaw portion may be an elongated portion of a jaw that extends between a corresponding gripping portion and an anchor portion. The jaw may comprise two jaw elements. The two elements may be spaced apart such that a slot is defined therebetween.

A slot. Each jaw may include one or more slots. The slot may be used to provide a channel or region for one or more features of the instrument to be positioned. For example, a cutting blade may be positioned in the slot. The slot may be substantially free of features or obstructions such that the cutting blade may be positioned therein. For example, while an instrument according to the teachings herein includes one or more tissue stops and/or struts, the tissue stops and/or struts are arranged to not block the cutting burr such that the cutting burr can translate, reposition, or otherwise move in the slot. That is, the tissue stop or portion thereof may be offset or disposed to one side of the slot.

The slot may be centered on a central plane or axis of the jaws or jaw assembly, or the slot may be offset from the longitudinal axis to one side of the jaws or jaw assembly or laterally spaced from the longitudinal axis. Preferably, the central plane of the slot is free of any tissue stop. The tissue stop may be disposed along an inner plane offset from the center plane or axis so as not to interfere with the reciprocating cutting blade, which may be centered on the center plane. However, in some configurations, the tissue stop may be disposed along a central plane or axis of the slot, however, the cutting blade is disposed along an edge of the slot or another plane that is not a central plane, such as along an outer or inner edge of the slot.

An arcuate portion. The one or more jaws or jaw elements can include one or more arcuate portions. The one or more arcuate portions may cooperate with the tubular member to move the jaw assembly, the one or more jaws, or both, between the open and closed positions. The arcuate portion may be at least partially flexible and/or resilient such that the jaw assembly, one or more jaws, or both, may move, bend, pivot, etc., upon application of pressure or force thereto. When the pressure or force is released or removed, the arcuate portion, jaw assembly, jaw, or combination thereof, can move, flex or relax back to the initial steady state position.

The one or more arcuate portions may be any feature that is at least partially higher, wider, and/or larger than the tubular member, an interior portion of the tubular member, an opening (e.g., distal opening) of the tubular member, or a combination thereof. For example, the one or more protrusions or arcuate portions may be thickened portions of the jaws or jaw elements, or protrusions attached to one or both of the jaws. The one or more arcuate portions may be portions that pull away or extend away from corresponding gripping portions of the same jaw. Thus, in electrosurgical forceps, anatomical features that are placed too far in the proximal direction between the jaws and thus disposed or positioned between the arcuate portions may not be coagulated. Passing the unpowered cutting blade through the uncondensed anatomical feature may then undesirably result in bleeding and/or trauma to the anatomical feature. Thus, the need for one or more tissue stops between the jaws is desirable to ensure that the anatomical feature is not placed too far in the proximal direction and beyond the energizing feature of the jaw assembly.

However, in some configurations, rather than flexing and bending the jaw assembly between the closed and open positions by applying a force or removing a force from one or more of the arcuate portions, the jaw assembly may include a hinge or pivot mechanism for pivoting the jaw assembly between the closed and open positions. In these hinge or pivot configurations, one or more of the jaws may be a rigid body or link. In these configurations, one or more tissue stops between the jaw assemblies can advantageously prevent the anatomical feature from being positioned too far in the proximal direction, thereby preventing the anatomical feature from being clamped in the hinge or pivot mechanism during opening and closing of the jaw assemblies.

An anchor portion. One or more jaws or jaw assemblies can include one or more anchor portions. One or more anchor portions can be used to anchor, attach or connect the jaws, the jaw assembly, or both to the handpiece. The anchor portion may be connected to one or more anchor rods. The anchor portion may be integrally formed with the anchor rod or may be connected thereto via any suitable method, such as welding, brazing, adhesive, stamping, etc. The anchor bar may be connected to one or more mechanisms in the handpiece such that when the user actuates one or more user controls, the mechanism, the anchor bar, and thus the jaws and/or jaw assembly, move. The anchor rod may be connected to one or more electrodes. The anchor rod may be electrically conductive. The anchor rod may be in electrical communication with a power source. For example, the anchor rod may be connected to a corresponding electrode at its distal end, and the anchor rod may be in communication with a power source, one or more electrical leads, wires, or a combination thereof at its proximal end. Preferably, the anchor rods may be insulated from each other such that a short circuit between the anchor rods is prevented.

A grip portion. The one or more jaws may include one or more gripping portions. The gripping portion may be used to affect manipulation of an object or anatomical feature. The gripping portion can be disposed at or near a distal region of the jaws. The gripping portion can be disposed between a distal end of the jaw and a corresponding distal end of the arcuate portion.

The gripping portion may include one or more regions having teeth, no teeth, protrusions, or a combination thereof. The one or more teeth or protrusions may be formed or cut into jaws or gripping portions by a suitable process or method, such as by grinding, electrical discharge machining, stamping, coining, etc. The gripping portion may include one or more grooves between the teeth to separate one tooth from another tooth. One or more teeth may have sharp points to aid in grasping anatomical features. Alternatively or in addition, one or more teeth may have flattened tops to distribute forces associated with the grasping force such that an object or tissue (especially a vessel wall) is not pierced or otherwise damaged when the object, vessel, or tissue is positioned between the jaws in the closed position.

The grip portion may be electrically conductive. That is, the grip portion may include one or more conductive portions. The conductive portion may be used to pass one or more therapeutic signals or currents between the gripping portion, the conductive portion, the object, the anatomy, or a combination thereof. The conductive portion may be or include an electrode or may be in communication with a power source. The conductive portion may be an entire portion of the grip portion. That is, the conductive portion can extend in a range or region between the distal tip of the jaw and the distal portion of the arcuate portion. In other configurations, the conductive portion may include a smaller area or portion than the entire grip portion. Preferably, the instrument is adapted to deliver opposing bipolar voltages to opposing gripping portions to provide sealing and coagulation of anatomical features disposed between the gripping portions so that the instrument can be used as a bipolar forceps.

The grip portion may include one or more insulating or non-conductive portions. One or more of the insulating or non-conductive portions may be insulating or otherwise not connected to an electrode or power source. Thus, one or more non-conductive portions may not be able to or be constrained from passing therapeutic current between jaws, objects, anatomy, or a combination thereof.

The grip portion may comprise a plate. The plates may be made of a conductive material, such as sheet metal. The plate may be an electrode. The plates may be in electrical communication with a power source and may be used to deliver therapeutic current from the power source to the anatomical feature or through the anatomical feature to another electrical conductor or plate to effect the anatomical feature disposed between the plates. The plates can be assembled to the insulator, which can then be attached or assembled to the jaws. The plate may include one or more features (i.e., teeth, toothless, etc.) of the grip portion described above.

A cutting knife. The instrument may include one or more cutting blades. The cutting blade may be used to cut an object or anatomical feature of interest, such as a blood vessel or tissue. The cutting blade may be a cutting blade or a surgical blade. The cutting blade may not be connected to a power source or electrically isolated from the power source; thus, the cutting blade may not deliver an electrical therapy current to affect anatomical features. Thus, the cutting blade may be a cold cutting blade or a mechanical cutting blade. The cutting blade may move or reciprocate within the slot by moving or manipulating one or more of the user controls on the hand piece. The cutting blade may be moved or extended to cut an anatomical feature captured between the jaw assemblies (e.g., when the jaw assemblies are in a closed or clamped position). The cutting blade may cut the anatomical feature after the anatomical feature is clamped and/or coagulated or sealed between the jaws of the jaw assembly. The cutting blade may also cut the anatomical feature when the jaw assembly is in the open position.

The cutting blade may be positioned between the jaws. The cutting blade may be disposed in a slot between two opposing jaw elements. As described above, the cutting blade may be centered in the slot axis. The cutting blade may be offset to one side of the slot axis (i.e., offset laterally from the central slot axis). The cutting knife may offset the slot axis toward one of the jaw elements.

Jaw shield. The jaw assembly may include one or more jaw shields. The jaw guard may be used to strengthen or stiffen the gripping portion of the jaw. Preferably, the jaw guard reinforces or reinforces the bendable and flexible gripping portion of the jaw. Advantageously, the jaw guard may make the entire jaw bendable or flexible such that the jaw may bend or flex between a closed position and an open position, as described above, while the gripping portion is made as rigid or inflexible as the remainder of the jaw such that anatomical features may be securely gripped between the jaws without deflecting or bending the jaws in the closed position. The jaw guard may be used to provide a grip or gripping pressure or force to the jaw assembly that is substantially uniform in the gripping portion. The jaw shield may be used to overcome beam deflection in one or both of the jaws when the jaw assembly is in or being moved into a closed position, particularly when an object, vessel, or tissue is disposed between the jaws.

The jaw guard may be attached to one or both of the jaws. That is, the jaw guard may be attached to the upper jaw, the lower jaw, or both. The jaw guard may be attached to the jaws in any suitable manner. For example, the jaw guard may be glued or overmolded onto the jaws. For example, the jaw guard may slide over or over the distal end of the jaws. For example, the jaw guard can be attached, connected, interwoven, welded, ultrasonically welded, staked, adhered, or a combination thereof to the jaws. For example, the jaw guard may be snapped into or onto a channel, groove, or protrusion in or on the corresponding jaw. The jaw guard may include one or more connection features that may cooperate with one or more undercut features on the jaw. One or more of the attachment features, the undercut features, or both, may be welded or fused together to prevent or limit removal and separation of the jaw guard and jaws. The one or more connection features, undercut features, or both may be one or more metal or plastic mating protrusions, grooves, nubs, posts; mating male and female dovetail portions, or other similar features suitable for connecting the spine and shroud.

In some configurations, the jaw guard can be irreversibly attached to the jaws. Irreversibly attached may mean that the jaw guard cannot be separated from the jaw without substantially damaging the jaw guard and/or the jaw. In some configurations, the jaw guard can be integrally formed with the jaws.

The jaw guard may be made of a suitable material. Preferably, the jaw shield is made of a material suitable for use in medical procedures, such as metal and/or plastic, for example. For example, the jaw shield may be formed by any suitable process, such as stamping, metal Injection Molding (MIM), or plastic injection molding. The jaw guard may be thermally insulated such that a thermal barrier may be provided between the jaws, the jaw assembly, or both. In some applications, a thermally insulating shield may be preferred such that thermal diffusion is limited or reduced. When the instrument is used in electrosurgery, the jaw guard may be electrically insulated to prevent electrical shorting.

Tissue stop. The instrument, jaw guard, or combination thereof may include one or more tissue stops. Advantageously, one or more tissue stops may be used to prevent, or at least limit objects or anatomical features from being positioned or extending beyond the proximal end of the gripping portion; beyond the proximal end of the conductive portion; or both. Advantageously, the one or more tissue stops can prevent, or limit the extension of an anatomical feature or object into the hinge, joint, or pivot mechanism of the jaw assembly, thereby reducing the chance of the anatomical feature being clamped therein. Advantageously, the one or more tissue stops may prevent, or limit the anatomical feature from extending into the region where the arcuate portion is located (i.e., beyond the distal end of the arcuate portion). Advantageously, the one or more tissue stops may prevent, or limit the anatomical feature from extending too far in the proximal direction and away from the gripping portion, thereby ensuring that sufficient gripping force is exerted on the desired portion of the anatomical feature. Advantageously, the one or more tissue stops may prevent, or limit the anatomical feature or object from extending too far in the proximal direction and away from the conductive portion, thereby ensuring that the entire desired portion of the anatomical feature may be electro-coagulated during the electrosurgical procedure.

The tissue stop may be a feature extending from one jaw, grip portion, or jaw guard toward the other jaw, grip portion, or jaw guard. The tissue stop may be attached to or integrally made with the jaws, the gripping portion, the jaw guard, or a combination thereof. The tissue stop may be, for example, a protrusion, a projection, a cantilevered member or portion, or a combination thereof. The tissue stop may be generally planar having an aspect ratio such that the length dimension is generally greater than the width dimension and the width dimension is generally greater than the thickness dimension. The tissue stop may have a constant thickness such that the two sides may be substantially parallel to each other. Alternatively, the thickness may taper slightly along the length of the tissue stop. In either case, the tissue stop will have parallel or nearly parallel first and second sides. Between the sides of the tissue stop and along the body of the tissue stop, there is a central plane about which the tissue stop may be substantially symmetrical.

One or more of the tissue stops may be made of the same material as the jaws, jaw guard, gripping portion, or a combination thereof. One or more tissue stops may be electrically conductive. Preferably, however, if the tissue stop is electrically conductive, the tissue stop does not participate in, or be micronized in, the electrical circuit for electrosurgical influencing anatomical features. One or more of the tissue stops may be made of an electrically insulating or non-conductive material. Thus, one or more of the tissue stops may be non-conductive.

One or more of the tissue stops may be disposed proximate the gripping portion. One or more of the tissue stops may be disposed in the grip portion. That is, a tissue stop may be disposed between the proximal and distal ends of the grip portion. One or more of the tissue stops may be disposed distally of the arcuate portion.

The tissue stop may be disposed along an outer edge or outer plane of the jaws, jaw guard, or both. The tissue stop may be disposed along an inner edge or inner plane of the jaws, jaw guard, or both. One or more tissue stops disposed at or along the outside edge or outer plane of the jaws or jaw shields may cooperate with one or more tissue stops disposed along the inside or inner plane of the jaws, jaw shields, or both to provide additional resistance and control of anatomical features from extending beyond the proximal end of the gripping portion, beyond the distal end of the arcuate portion, or both, as compared to the case where the tissue stops are disposed only at or along the outside edge or outer plane of the jaws. That is, if, for example, the anatomical feature is placed in an offset in the jaw assembly or in a position that facilitates an opposing outer or outer edge of the jaw (where the tissue stop cannot contact the anatomical feature to provide a blocking function), the tissue stop disposed only at the outer or outer edge of the jaw may not be effective to limit, prevent, or inhibit the anatomical feature from extending proximally beyond the gripping portion or the conductive portion. Similarly, if, for example, the anatomical features are thin or narrow and are capable of free transfer between tissue stops without the tissue stops contacting the anatomical features to provide a blocking function, a jaw comprising tissue stops disposed at two opposing outer edges of the jaw or jaw guard may not be effective to limit, prevent, or inhibit the anatomical features from extending proximally beyond the gripping portion or conductive portion.

One or more tissue stops may be disposed on the upper jaw or jaw guard and extend toward the lower jaw or jaw guard, and one or more tissue stops may be disposed on the lower jaw or jaw guard and extend toward the upper jaw or jaw guard.

Jaw assemblies having multiple tissue stops can include tissue stops having the same height or different heights. In some configurations, the height of the tissue stop on the upper jaw or jaw guard may be greater than the height of the tissue stop on the lower jaw, or vice versa. Two or more tissue stops may be aligned with each other. That is, the center planes of the tissue stops can be coplanar, aligned, or centered about the same plane, and one tissue stop can be distally positioned relative to another tissue stop or tissue stops to prevent the tissue stops from interfering with one another, or to keep the tissue stops from interfering with one another when the jaw assembly is in or moved into the closed position.

In some configurations, one or more tissue stops can be received in a notch, gap, or slot of an opposing jaw or jaw guard such that the jaw assembly can be moved into a closed position without the tissue stop interfering with closure. In the closed position, one or more tissue stops can be received in a slot defined between two opposing jaw elements. Preferably, in the closed position, one or more tissue stops are received into the slot, but are positioned along the edge of the slot so as not to interfere with the cutting blade or other element that may also be positioned in the slot.

In some configurations, the height of one or more of the tissue stops can be short enough to eliminate the need to receive the tissue stop in a notch, gap, or slot of the opposing jaw or jaw shield when the jaw assembly is moved into the closed position. In these configurations, preferably, tissue stops are disposed on both the opposing jaws or jaw shields. In these configurations, preferably, the height of the tissue stop extending from each jaw or jaw guard is still high enough to overlap each other when the jaw assembly is in the open position. Such an arrangement would still advantageously limit or prevent the anatomical feature from being transferred proximally or extending beyond the tissue stop and/or the gripping portion.

Overlapping of tissue stops may mean that the free end of one tissue stop extends beyond the gripping surface of the opposing jaw when viewed from the side of the instrument or jaw assembly, and when the jaw assembly is in the open position. Overlapping of tissue stops on opposing jaws may mean that the free end of the tissue stop on one jaw extends beyond the free end of the tissue stop on the opposing jaw when viewed from the side of the instrument or jaw assembly, and when the jaw assembly is in the open position.

And (5) a pillar. One or more of the instrument, one or more jaws, one or more jaw shields, tissue stops, or a combination thereof may include one or more struts. The struts may be used to provide stability to one or more of the tissue stops. That is, when the jaw assembly is in the open position, in the closed position, or is moving into the closed position, the tissue stop can contact the post such that the tissue stop abuts the post. Since the tissue stop rests on the post, the tissue stop may be limited or prevented from moving, flexing or pushing in the proximal direction. For example, when the anatomical feature is positioned between opposing jaws, the anatomical feature can contact the tissue stop and then urge the tissue stop in a proximal direction. However, as the tissue stop abuts or abuts the post, the tissue stop may be restricted from moving or pushing in a proximal direction, which may thus provide stability to the tissue stop. The one or more struts may extend from an outer edge or an outer edge of the tissue stop, from an inner edge or an inner edge of the tissue stop, or both. The struts disposed on the lower tissue stop may provide stability to the tissue stop disposed on the upper jaw or the guard and/or the struts disposed on the upper tissue stop may provide stability to the tissue stop disposed on the lower jaw or the lower guard. The post may be a protrusion or extension from a tissue stop, jaw shield, or combination thereof.

Struts may also be used to provide additional tissue blocking surface area. That is, the struts may also serve to prevent, inhibit or limit the anatomical feature from extending beyond the proximal end of the grip portion or the conductive portion in the same or similar manner as the tissue stop. For example, struts may prevent thin anatomical features from being transferred between two adjacent or laterally disposed tissue stops. Alternatively, the struts may be independently used to prevent the anatomical feature from being positioned proximal to the gripping portion by extending outwardly from the tissue stop, extending inwardly from the tissue stop, or both. Preferably, however, the struts do not obstruct the cutter slots so that the cutter can move or reciprocate to cut anatomical features. When the jaw assembly is moved into the closed position, the post can be received or fit into the arcuate portion on the opposing jaw so as not to interfere with the closing of the jaw assembly.

As used throughout this specification, "centered on …" refers to a plane that is aligned with, coplanar with, centered on or around, or the same as another plane. For example, the tissue stop can be centered on a central plane of the jaw assembly. This means that the center plane of the tissue stop is aligned with, coplanar with, centered on or around, or identical to the center plane of the jaw assembly, and thus one side of the tissue stop is disposed on each side of the center plane of the jaw assembly and on each side of the tissue stop.

As used throughout this specification, "inner plane" refers to a plane that is not an outer plane. "inner" and "outer" are terms of relative position. Thus, a first plane is "inboard" if it is closer to the center plane than a second plane. Any plane closer to the outside is an "outer plane". Thus, a second plane is "outboard" if it is closer to the outboard plane than the first plane. Thus, the plane at the outer edge or side of the jaw is the "outer plane of the jaw". Of course, there is an outer plane at the other outer plane or outer edge of the jaws. Any and all planes (these planes being generally parallel) and therebetween are "inner planes of the jaws".

"Inside of tissue stop. "each tissue stop will have one side closer to the central axis of the slot (inner side or inner plane of the tissue stop) and one side further from the central axis of the slot (outer side or outer plane of the tissue stop). It is noted that in this definition, "inner"/"outer" does not necessarily need to be defined relative to the true center plane of the jaw assembly or the width of the jaws. For example, if the center slot is significantly skewed to the left such that the tissue stop placed on the right edge of the slot is entirely present on the left side of the true center plane of the jaw assembly or jaw, the "inner" will be the left side of the tissue stop and the "outer" will be the right side of the tissue stop.

As used herein, "juxtaposed" means that an edge or side of a particular feature is disposed or disposed adjacent or near a side or edge of another feature. Gaps may exist between juxtaposed features, or features may be arranged "line-to-line" with little or no gaps therebetween. Juxtaposed may mean that a side, plane or feature is close to another side, plane or feature, but is able to slide across each other.

Fig. 1 shows an instrument 10. Instrument 10 includes a tubular member 12, a jaw assembly 14, and a handpiece 16. Jaw assembly 14 includes a first jaw 18 and a second jaw 20. The handpiece 16 includes one or more user controls including a lever 22, a trigger 24, a wheel 26, and a button 28. The instrument 10 may be in communication with a power source 30.

Fig. 2 shows a first jaw 18, which may also be a second jaw 20. Jaws 18,20 include a gripping portion 32 and an anchoring portion 34. The jaws 18,20 include a jaw guard 36. Jaws 18,20 include a pair of spaced apart jaw portions 38,40. A slot 42 is defined between the two jaw portions 38,40 and extends to the distal ends of the jaws 18, 20. Each jaw portion 38,40 includes an arcuate portion 44.

In the following fig. 3-7, reference will be made to various features of the jaws 18,20 and/or jaw portions 38, 40. It should be appreciated that "a" following the reference numerals corresponds to the features associated with the jaws 18, and "b" following the reference numerals corresponds to the features associated with the jaws 20.

Fig. 3 illustrates jaw assembly 14. The jaw assembly 14 is in an open position. The tubular member 12 includes a mouth or distal opening 46. Moving tubular member 12 in a distal direction away from handpiece 16 and into contact with arcuate portion 44, and then onto arcuate portion 44 causes one or both of opposing jaws 18,20 to move or flex toward each other, thereby moving jaw assembly 14 from an open position to a closed position (not shown).

Alternatively or additionally, moving jaw assembly 14 in a proximal direction toward handpiece 16 such that arcuate portion 44 contacts a mouth or distal opening 46 of tubular member 12 also serves to move or flex one or both of jaws 18,20 toward each other, thereby moving jaw assembly 14 from an open position to a closed position.

Of course, when the jaw assembly 14 is in the closed position, moving the tubular member 12 proximally relative to the handpiece 16 and/or moving the jaw assembly 14 distally relative to the handpiece 16 serves to allow one or both of the jaws 18,20 to move or flex away from each other such that the jaw assembly moves or flexes from the closed position to the open position.

With continued reference to fig. 3, jaw portion 38b includes an inner planar or medial edge 48b, and jaw portion 40b includes an inner planar or medial edge 50b. The slot 42b can be defined by two opposing outer edges, which can be an edge 48b of the jaw portion 38b and an edge 50b of the jaw portion 40 b. The slot 42b can be centered about a central axis or plane 56 of the jaw 20 that extends between the edges 48b,50 b.

Similarly, jaw portion 38a includes an inner planar or medial edge 48a (see fig. 4 b), and jaw portion 40a includes an inner planar or medial edge 50a. The slot 42a can be defined between two opposing outer edges, which can be the two aforementioned edges 48a,50a of the jaw elements 38a,40 a. The slot 42a can be centered about a central axis or plane 56 of the jaw 18 extending between the edges 48a,50a. Slots 42a and 42b may be the same plane or coplanar. The jaw portions 38a,40a are joined together at the distal leading edge portion 52a, and the jaw portions 38b,40b are joined together at the distal leading edge portion 5 b.

The cutting blade 54 is received in the slots 42a,42b and is movable therein. For example, the cutting blade 54 may be moved by manipulating one of the user controls on the handpiece 16 such that the cutting blade 54 moves toward and away from the distal leading edge portions 52a,52 b. The gripping portions 32a,32b of one or both jaws 18,20 can be electrically conductive (i.e., conductive portions), or one or both of the gripping portions 32a,32b can include electrodes 60a,60b in electrical communication with a power source 30 (FIG. 1). Each jaw 18,20 includes a respective jaw shield 36a,36b.

It should be appreciated that any of the tissue stops shown in fig. 4 a-7, or described in this disclosure, can be added to the jaw assembly shown in fig. 3. Similarly, it should be appreciated that the cutting blade 54 shown in fig. 3 may be added to any of the jaw assemblies shown in fig. 4 a-7, or described in this disclosure.

Fig. 4a and 4b illustrate jaw assembly 14. Each jaw 18,20 includes a respective jaw shield 36a,36b. Each jaw shield 36a,36b includes a respective tissue stop 64a,64b. Tissue stop 64a extends from jaw 18 to jaw 20 or toward jaw 20, and tissue stop 64b extends from jaw 20 to jaw 18 or toward jaw 18. Each tissue stop 64a,64b is disposed proximal to a respective gripping portion 32a,32 b. Tissue stops 64a,64b overlap each other when jaw assembly 14 is in the open position and cooperate to limit, prevent, or inhibit anatomical features from exceeding the proximal ends 62a,62b of the respective gripping portions 32a,32 b. Thus, the anatomical feature is maintained in position between the gripping portions 32a,32b such that the entire anatomical feature may be affected or coagulated between the gripping portions 32a,32 b. Without tissue stops 64a,64b, a portion of the anatomical feature may inadvertently or unintentionally extend beyond one or both of the proximal ends of the gripping portions 32a,32b, which may result in the portion of the anatomical feature not coagulating. When the cutting blade 54 of fig. 3 extends or advances through an uncondensed portion of an anatomical feature, the anatomical feature may undesirably bleed.

At least one of the tissue stops, for example tissue stop 64b, includes a post 66. The post 66 extends laterally from an outer or lateral surface 74b of the tissue stop 64 b.

As perhaps best shown in fig. 4b, tissue stops 64a,64b are centered on inner plane 68 of jaws 18, 20. The inner plane 68 is offset from the central plane or axis 56 of the jaws 18,20 or jaw assembly 14. The central plane or axis 56 may also be the central plane or axis of the slots 42a,42b, but is not necessarily the central plane or axis of the slots 42a,42b (see, e.g., fig. 5). The inner planar surface 68 is offset from the outer planar or outboard edges 70a,70b of the jaw portions 38a,38 b. The inner plane 68 is offset from the outer plane or outer side edges 72a,72b of the jaw portions 40a,40 b. The offset of the inner plane 68 can advantageously provide clearance for the cutting blade to be reciprocated, which clearance can occur along a longitudinal axis or central plane of the jaw assembly.

With continued reference to fig. 4b, the outer planar or lateral edge 74a of the tissue stop 64a is juxtaposed, aligned or adjacent to the inner planar or medial edge 48a of the jaw element 38 a. The outer planar or lateral edge 74b of the tissue stop 64b is juxtaposed, aligned or adjacent to the inner planar or medial edge 48b of the jaw element 38 b.

As jaw assembly 14 is moved into the closed position, outer planar or lateral edge 74a of tissue stop 64a is also juxtaposed, aligned or adjacent to inner planar or medial edge 48b of jaw element 38 b. Similarly, when jaw assembly 14 is moved into the closed position, outer or outboard edge 72b of tissue stop 64b is also juxtaposed, aligned or adjacent to inner or inboard edge 48a of jaw element 38 a. According to this above arrangement of tissue stops 64a,64b, in the open and closed positions of jaw assembly 14, slots 42a,42b remain clear such that cutting blade 54 (fig. 3) may extend through gap 42. When jaw assembly 14 is moved into the closed position, tissue stop 62a is at least partially received in slot 42b, and tissue stop 62b is at least partially received in slot 42 a.

While fig. 4b shows the slots 42a,42b as being generally centered about a central axis or plane 56 of the jaws 18,20 or jaw assembly, fig. 5 illustrates that the slots 42a,42b need not be centered about the central axis or plane 56 of the jaws 18, 20.

More specifically, FIG. 5 illustrates that the central axis or plane 76 of the slots 42a,42b is offset or skewed from the central axis or plane 56 of the jaws 18,20 or jaw assembly in a direction toward the jaw portion 38. It should be appreciated that, although not shown, the central axes 76 or planes of the slots 42a,42b can be offset or skewed from the central axis or plane 56 toward the other jaw portions 40.

In addition, each tissue stop 64 has a thickness that includes a first side 80 and a second side 82 that are centered about a tissue stop axis or plane 82, which may also be the inner plane 68 of the jaws 18,20 or jaw assembly 14. With respect to the central axis or plane 56 of the jaws 18,20, the first side 78 can be defined as an outer or outer edge and the second side 80 can be defined as an inner or inner edge. However, with respect to the central axis or plane 76 of the slot 42, the first side 78 may be defined as an inner or inboard edge and the second side 80 may be defined as an outer or outboard edge.

Fig. 6 shows jaw assembly 14. Each jaw 18,20 includes a respective jaw shield 36a,36b, and each jaw shield 36a,36b includes a respective tissue stop 64a,64b. Each jaw 18,20 includes a gripping portion 32a,32b. Each jaw 18,20 includes a slot 42a,42b defined between two opposing corresponding outer edges 48a,50a and 48b,50 b.

Each tissue stop 64a,64b is generally U-shaped and includes an inner, inner or inboard leg 84a,84b and an outer, outer or outboard leg 86a,86b, with a channel defining a gap 88a,88b between the inner and outer legs 66a,66b, 68a,68 b. The inner leg, leg or leg 84a,84b is centered on an inner plane of the jaws 18,20 that is offset from a central axis or plane of the jaws 18, 20.

Tissue stops 64a,64b are positioned proximal to the gripping portions on first jaw 18 and second jaw 20. The tissue stops 64a,64b may cooperate to limit, prevent, or inhibit anatomical features from exceeding the proximal ends 62a,62b of the respective gripping portions 32a,32 b. Thus, the anatomical feature is maintained between the gripping portions 32a,32b such that the entire anatomical feature may be affected, gripped, clamped, and/or coagulated between the gripping portions 32a,32 b. Without tissue stops 64a,64b, a portion of the anatomical feature may extend beyond the proximal end of the gripping portions 32a,32b, e.g., into the region of the arcuate portions, which may result in the portion of the anatomical feature not coagulating. When the cutting blade 54 of fig. 3 extends or advances through an uncondensed portion of an anatomical feature, the anatomical feature may undesirably bleed.

The inner leg, leg or leg 84a of the tissue stop 64a includes an outer edge or inner plane 90a that is coplanar or aligned with the inner plane or edge 50a of the jaw portion 40 a. In the closed position, at least a portion of the inner leg, inner leg or inner leg 84a extends into the slot 42b, and at least a portion of the outer edge or outer or inner plane 90a of the inner leg, inner leg or inner leg 84a is juxtaposed with the inner plane or inner edge of the jaw portion 40b of the slot 42 b.

When the jaw assembly 14 is in the open position, at least a portion of the inner leg 84a and the outer leg 86a of the tissue stop 64a overlap the second jaw 20 at a location proximal to the end 62a of the gripping portion 32a of the first jaw 18, proximal to the end 62b of the gripping portion 32b of the second jaw 20, or both.

The outer, outer or lateral leg 86a of tissue stop 64a includes an inner edge or outer planar surface 92a. In the closed position, the outer leg, outer leg or outer leg 86a remains on the outside of the jaw shield 36b and the inner edge or outer plane 92a is juxtaposed with the outer side surface or plane 70b of the jaw 20 or jaw shield 36 b. In the closed position, the channel 88a is adapted to receive at least a portion of the jaw element 40b and/or the gripping portion 32 b.

The inner or medial leg 84b of the tissue stop 64b includes an outer or inner edge or plane 90b that is coplanar or aligned with the inner or medial edge 50b of the jaw portion 38 a. In the closed position, the inner leg 84b extends into the slot 42a, and an outer or inner plane 90b of the inner or inner leg 84b is juxtaposed with the inner or inner plane 48a of the jaw portion 38 a. The outer, outer or lateral leg 86b of tissue stop 64a includes an inner edge or outer planar surface 92b. In the closed position, the outer or outer legs 86b remain on the outside of the jaw shield 36a, and the inner edge or outer plane 92b is juxtaposed with the outer side surface or plane 70a of the jaw 18 or jaw shield 36 a. In the closed position, the channel 88b is adapted to receive at least a portion of the jaw element 38a and/or the gripping portion 32 a.

According to this above arrangement of tissue stops 64a,64b, in the open and closed positions of jaw assembly 14, slots 42a,42b remain clear such that cutting blade 54 (fig. 3) may extend through gap 42.

Fig. 7 illustrates the jaw assembly 14. Each jaw 18,20 includes a respective jaw shield 36a,36b. The jaw guard 36a includes a tissue stop 64a that extends from the jaw 18 to the jaw 20 or toward the jaw 20, and the jaw guard 36b includes tissue stops 64b1 and 64b2 that both extend from the jaw 20 to the jaw 20 or toward the jaw 20. Tissue stops 64a,64b1, and 64b2 are positioned proximal to the gripping portions on first jaw 18 and second jaw 20.

Tissue stop 64a is centered on an inner plane of jaws 18,20 that is offset from a central axis or plane of jaws 18, 20. Tissue stop 64a includes an outer planar or outboard edge 74a that is aligned with an inner planar or inboard edge (not shown, see fig. 4 b) of jaw portion 38 a. In the closed position, the outer planar or outboard edge 74a is aligned or juxtaposed with an inner planar or inboard edge (not shown, see fig. 5) of the jaw portion 38 b.

Tissue stop 64b1 includes an inner plane or edge (not shown) that aligns with outer plane or outer edge 70b of jaw portion 38 b. In the closed position, the inner edge or edge of tissue stop 64b1 is aligned or juxtaposed with the outer planar surface 70a or outer edge 72a of jaw portion 38 a. Tissue stop 64b2 includes an inner plane or edge 94a that is aligned with an outer plane or outer edge (not shown) of jaw portion 38 b. In the closed position, the inner or inner edge 94a of the tissue stop 64b2 is aligned or juxtaposed with an outer planar or outer edge (not shown) of the jaw portion 40 a.

The tissue stops 64a,64 b1, and 64b2 may cooperate to limit, prevent, or inhibit anatomical features from exceeding the proximal ends 62a,62b of the respective grip portions 32a,32 b. Thus, the anatomical feature is maintained between the gripping portions 32a,32b such that the entire anatomical feature may be affected, gripped, clamped, and/or coagulated between the gripping portions 32a,32 b. Without tissue stops 64a,64b, a portion of the anatomical feature may extend beyond the proximal end of the gripping portions 32a,32b, e.g., into the region of the arcuate portions, which may result in the portion of the anatomical feature not coagulating. The medial placement of the tissue stop in the jaw assembly may more effectively limit, prevent, or inhibit the anatomical feature from extending beyond the proximal ends 62a,62b of the respective gripping portions 32a,32b than the lateral placement of the tissue stop alone, as the tissue stop disposed at the outer or lateral edges alone may not effectively limit, prevent, or inhibit the anatomical feature placed in the jaw assembly, but is offset toward the opposite lateral sides of the jaws and does not reach the tissue stop. Furthermore, tissue stops disposed at the outer side or edge may not be effective in preventing or preventing thin or narrow anatomical features from extending beyond the proximal end of the gripping portion. When the cutting blade 54 of fig. 3 extends or advances through an uncondensed portion of an anatomical feature, the anatomical feature may undesirably bleed.

The illustrations and descriptions provided herein are intended to provide those skilled in the art with an understanding of the teachings, their principles, and their practical application. Those skilled in the art may adapt and apply the teachings in its various forms, as may be best suited to the requirements of a particular use. Thus, the specific embodiments of the present teachings are not intended to be exhaustive or limiting of the teachings. The scope of the teachings is, therefore, not to be determined with reference to the above detailed description, but instead with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. The disclosures of all articles and references, including patent applications and publications, are incorporated by reference for all purposes. Other combinations of documents are also possible, as will be gathered from the following claims, which are hereby incorporated by reference into this written description.

The disclosures of all articles and references, including patent applications and publications, are incorporated by reference for all purposes.

Multiple elements, components, parts, or steps may be provided by a single integrated element, component, part, or step. Alternatively, a single integrated element, component, means, or step may be divided into separate pluralities of elements, components, means, or steps. The disclosure that describes an element, component, or step with reference to "one" or "an" is not intended to exclude additional elements, components, or steps.

It is to be understood that the above detailed description is intended to be illustrative, and not restrictive. Many embodiments and many applications other than the examples provided will be apparent to those of skill in the art upon reading the above description. The scope of the teachings should, therefore, be determined not with reference to the above description, but instead should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. The disclosures of all articles and references, including patent applications and publications, are incorporated by reference for all purposes. The omission of any aspect of the subject matter disclosed herein by the following claims is not intended to forego the right to such subject matter, nor should the inventors regard such subject matter as not be considered to be part of the presently disclosed subject matter.

Claims

1. An instrument, the instrument comprising:

A clamp, the clamp comprising:

A jaw assembly, the jaw assembly comprising:

i) A first jaw including a gripping portion extending at least partially around a first inner knife slot; and

Ii) a second jaw including a gripping portion extending at least partially around the second inner knife slot;

Wherein the jaw assembly is movable between an open position and a closed position,

Wherein the first jaw includes a first tissue stop having at least a portion received by the second inner knife slot when the jaw assembly is in the closed position, and

Wherein the second jaw includes a second tissue stop extending from the second jaw toward the first jaw.

2. The instrument of claim 1, wherein the instrument comprises a knife that is extendable distally beyond the first tissue stop into the first and second inner knife slots when the jaw assembly is in a closed position.

3. The instrument of claim 1, wherein the first tissue stop is adapted to prevent anatomical features from extending proximally beyond a proximal end of the gripping portion of the first jaw, a proximal end of the gripping portion of the second jaw, or both.

4. The instrument of claim 1, wherein the first jaw is electrically conductive, the second jaw is electrically conductive, or both the first jaw and the second jaw are electrically conductive.

5. The instrument of claim 1, wherein the first tissue stop is non-conductive.

6. The instrument of claim 1, wherein each of the first and second inner knife slots is defined between two opposing outer edges of a corresponding one of the first and second jaws.

7. The instrument of claim 1, wherein the second tissue stop is adapted to prevent anatomical features from extending proximally beyond a proximal end of the gripping portion of the first jaw, a proximal end of the gripping portion of the second jaw, or both.

8. The instrument of claim 1, wherein the first tissue stop and the second tissue stop are both centered on an inner plane of the first jaw.

9. The instrument of claim 8, wherein the first tissue stop is longitudinally offset from the second tissue stop such that the first and second tissue stops do not interfere with each other when the jaw assembly moves the closed position.

10. The instrument of claim 9, wherein when the jaw assembly is in the open position, a distal tip of the first tissue stop extends a distal tip between the second tissues such that anatomical features are prevented from extending proximally beyond a proximal end of the gripping portion of the first jaw, a proximal end of the gripping portion of the second jaw, or both.

11. The instrument of claim 1, wherein the second jaw includes a third tissue stop extending from the second jaw toward the first jaw.

12. The instrument of claim 11, wherein the third tissue stop is adapted to prevent anatomical features from extending proximally beyond a proximal end of the gripping portion of the first jaw, a proximal end of the gripping portion of the second jaw, or both.

13. The instrument of claim 11, wherein the second tissue stop and the third tissue stop are located on opposite sides of the second inner knife slot of the second jaw.

14. The instrument of claim 1, further comprising a post extending laterally from the first tissue stop away from the first inner knife slot.

15. The instrument of claim 1, wherein the first tissue stop is generally U-shaped and includes an inner leg, an outer leg, and a gap defined between the inner leg and the outer leg.

16. The instrument of claim 15, wherein at least a portion of the gripping portion of one of the first and second jaws is received in a gap of a tissue stop attached to the other of the first and second jaws when the jaw assembly is in the closed position.

17. The instrument of claim 15, wherein at least a portion of the inner leg is received in the second inner knife slot of the second jaw when in the closed position.

18. The instrument of claim 15, wherein the gap is configured to receive at least a portion of the raised gripping portion of the second jaw when in the closed position.

19. An instrument, the instrument comprising:

A clamp, the clamp comprising:

A jaw assembly, the jaw assembly comprising:

Wherein the first jaw includes a first tissue stop having at least a portion that is received by the second inner knife slot when the jaw assembly is in a closed position, wherein the first tissue stop is generally U-shaped and includes an inner leg, an outer leg, and a gap defined between the inner leg and the outer leg, wherein the gap is configured to receive at least a portion of a raised gripping portion of the second jaw when in the closed position, and